1.Gender Identification

Male

Female

Non-Binary

Choose Not to Identify

2.What is your ethnic background?

White

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Other/Two or More Races

Choose Not to Identify

3.Are you a Veteran of the U.S. Armed Forces or a surviving spouse?

Yes, I am a Veteran or surviving spouse

No, I am not a Veteran or surviving spouse

Choose not to disclose

4.What state do you reside in?

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia (DC) Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

5.How did you hear about this call for entry?

Online

Friend

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Other (please specify)